Care home error rate of liquid medicine doses 4 times higher than pills

Feb 07, 2011

Care home residents are more than four times as likely to get the wrong dose of medicine when it is in liquid form as they are when given pills/capsules provided in a dispenser, indicates research published online in BMJ Quality and Safety.

Dispensers, known as monitored dosage systems or MDS for short, comprise a tray or cassette with compartments for one or more doses for a particular day or a given time. They are intended to simplify drug rounds for care home staff and cut the risk of mistakes.

But swallowing difficulties mean that some elderly people need to take their medicines in liquid form, while drugs, such as inhalers, injections, , and those requiring refrigeration, cannot be provided in dispensers.

Most care homes therefore usually use two parallel systems of drug administration, say the study authors, who set out to compare the dosing error rates in these systems.

Included in the research were 233 residents in 55 UK care homes, which were selected to provide a representative sample of different sizes, ownership, and type of care offered.

Dosing errors were picked up during the course of two drug rounds for each of the residents and from data collected from error reports from a recent previous study of the same group of care home residents.

Tablets/capsules in dispensers accounted for more than half (53%) of medicines given to the residents, with just under a third (29%) of not provided in dispensers. Around one in nine drugs was in liquid form and around 4% were inhalers. The remainder were injectables/creams/eye-drops.

The results showed that mistakes were more than four times as likely to be made with a liquid medicine as they were with a tablet/capsule from a dispenser.

And the likelihood of a mistake was 19 times higher when using a cream, injection or eye drop, and more than 33 times as likely when an was used.

Although the error rate was lower, mistakes were also made with tablets/capsules. The rate was twice as high for tablets/capsules provided in the manufacturer's original packing as it was for pills provided in a dispenser.

Older people are already at much higher risk from drug errors and the subsequent consequences, because they often need to take several medicines for several ailments, and they metabolise drugs differently, say the authors

But although dispensers seem to carry less risk of a dosing error, they are not without their difficulties, say the authors.

They require the manual transfer and checking of pills, which is both labour-intensive and expensive, and this is not easy when several tablets are needed for one compartment, they point out.

But for those medicines that cannot be provided in this way, care home staff need better training in how to administer them safely, say the authors.

Explore further: Seniors successfully withdraw from meds

add to favorites email to friend print save as pdf

Related Stories

Nano drops from the one-way pack

Sep 15, 2004

New dispenser system made of plastic reduces costs for use of micro dispensers A two-component micro dispenser system developed at the Institut für Mikrotechnik Mainz GmbH (IMM) produces nano drops ...

New medics in death spike

Jun 02, 2010

Are new medical residents a threat to patients? According to Dr. David Phillips and Gwendolyn Barker from the University of California, San Diego in the US, fatal medication errors peak in July in teaching hospitals in particular, ...

Recommended for you

Seniors successfully withdraw from meds

10 hours ago

Elderly people have proved receptive to being de-prescribed medications, as part of a trial aimed at assessing the feasibility of withdrawal of medications among older people.

Flu vaccine for expectant moms a top priority

Sep 18, 2014

Only about half of all pregnant women in the U.S. get a flu shot each season, leaving thousands of moms-to-be and their babies at increased risk of serious illness.

Experts want restrictions on testosterone drug use (Update)

Sep 17, 2014

Federal health experts said Wednesday there is little evidence that testosterone-boosting drugs are effective for treating common signs of aging in men and that their use should be narrowed to exclude millions of Americans ...

User comments : 0